A. Field of the Invention
The present invention relates to articles and methods used in the fabrication of dental prostheses such as crowns and bridges made of various combinations of metal and ceramic materials and used to overlie or replace imperfect or missing teeth. More particularly, the invention relates to a system for use in fabricating crowns and bridges, the system including an apparatus and method for making from a mold or impression of a patient's teeth a dental model cast which is formed from solidified liquid die stone poured into the mold and an upper portion of a tray. The dental model cast is segmentable into die segments, each of which has both horizontally protruding ribs and grooves for releasably engagement with complementary-shaped grooves and ribs formed in a support tray. Individual die segments are optionally fitted with a pin which protrudes downwardly from the die segment, the pin facilitating gripping and manipulating of the die during various fabrication operations performed by a dental technician.
B. Description of Background Art
A dental procedure which is routinely used to restore function and aesthetic appearance to a person's mouth after a tooth has become broken, structurally degraded by disease or removed entirely, consists of capping or replacing the tooth with a prosthetic restoration, such as a crown or bridge. One form of dental prosthesis or artificial tooth replacement which is widely used consists of a cap or crown for a tooth that is made of a resin, molded ceramic material, a precious metal such as gold or an alloy thereof, or a layered combination of metals and resins or ceramic materials. Various combinations of the foregoing materials provide tooth restorations which possess requisite durability and aesthetic appearance, as well as sufficient hardness to be suitable for chewing foods. The process of fabricating tooth restorations has been in use for a substantially long time, and includes a well-defined sequence of steps, which are briefly summarized below.
According to a first step in existing methods of fabricating dental prostheses or artificial replacement teeth, a negative impression mold is made of a group of a patient's teeth, including missing, broken or decayed teeth which are to be repaired or replaced and teeth which are laterally adjacent to the defective teeth. Such impressions are typically made by positioning within the mouth of a patient, adjacent to teeth to be restored, a shallow curved tray which contains a polymer material such as alginate, elastomer, hydrocolloid or a polyether, which is capable of being indented by a tooth, and forming and retaining a stable impression of the tooth. The impression material is initially in the form of a putty, slurry or thick paste which rapidly solidifies at ambient room temperature and pressure. The tray is inserted into a patient's mouth positioned generally horizontally and in vertical alignment with a subject area of the teeth, and the patient bites down on the tray, or the tray is pressed into contact with the teeth, thus pressing the teeth into the viscous semi-liquid mold impression material held by the tray. After a few minutes, the mold impression material solidifies into a rubber-like elastomeric state which has formed therein precise negative impressions of teeth in a subject area of the patient's mouth.
Dental impression trays for use as described above are available in a variety of styles. One type tray has an arcuately curved plan-view shape which is similar to the curved arrangement of teeth in the jaw. The curved arc length of the tray approximates that of about one half an upper or lower jaw and hence is referred to as a quadrant tray. A flat, paddle-like handle protruding horizontally outwards from one end of the tray is usually provided, to facilitate inserting and removing the tray from a patient's mouth. A typical quadrant tray has on one side thereof a curved trough for receiving impression mold material, may be used to make impressions of upper or lower jaw quadrants and is referred to as a standard quadrant or single-bite tray.
Since an important structural feature of a dental prosthesis is proper registration and biting contact or occlusion between the prosthesis and teeth located in the opposing jaw, it is desirable to make an impression of occluding teeth in the opposing jaw in addition to the impression made of teeth that are to be restored. Therefore, it has been a trend in dentistry for the dental professional to simultaneously make impressions of teeth that are to be restored and occluding teeth in the opposing jaw. A convenient method for simultaneously making restorative and opposing impressions utilizes a tray which has a plan-view shape similar to that of a single-bite, standard quadrant impression tray, but which has upper and lower troughs for holding mold impression material in both upper and lower sides of the tray. Both the upper and lower troughs of these “double-bite” or “triple” trays are filled with viscous impression material and inserted into the patient's mouth between the upper and lower jaws in vertical alignment with teeth to be restored, whereupon the patient bites down on the tray, simultaneously forming impressions of upper and lower teeth.
After impressions of teeth have been made in the manner described above, and the mold impression material solidified, the tray holding solidified mold impression material containing negative impressions of a patient's teeth is removed. The mold, typically referred to as an “impression,” is then used to make positive replicas of teeth by pouring a semi-liquid molding material such as plaster of Paris, or die stone, into the depressions formed in the impression, which are accurate negative replicas of the teeth. After the die stone has solidified into a hard stone-like casting, or cast, the cast is removed from the impression, a task which is facilitated by the fact that the impression material is elastomeric, enabling it to be readily peeled away from the die. The casting is then used to fabricate one or more tooth restorations or prostheses in the following manner.
A master cast, i.e., a cast which includes replicas of teeth which are to be restored, is partitioned into one or more individual segments and/or dies, each consisting of a replica of a tooth which is to be replaced by or fitted with a dental prosthesis. Partitioning of a master cast into die segments is typically accomplished by making parallel vertical saw cuts through the master cast. The individual die segment or segments are then used as three-dimensional models or templates for fabricating crowns or bridges. In general, the exterior surfaces of the prosthesis cannot simply replicate those of the die segments. This is because the occlusal surface of the prosthetic tooth restoration, and to a lesser extent, lateral surfaces of the restoration, may require contouring which is different from that of the die segment. For example, the process of fabricating crowns for diseased or damaged teeth entails grinding decayed or broken outer portions of the tooth down until a stump of healthy dentin or enamel remains, a procedure referred to as “prepping” the tooth. Obviously, a crown which is fabricated to fit onto a stump must have a substantially different, tooth-like shape rather than a stump-like shape.
From the foregoing discussion, it can be appreciated that the fabrication of dental prosthesis models from die segments is a labor-intensive task requiring the skills of a prosthodontist or skilled, experienced, dental lab technician. Fabrication of prosthetic dental models typically requires that die segments be contoured by applying a workable material to exterior portions of the die segment, and sculpting the material. The die segment is then replaced into the space in the master cast from which it has been removed, and proper occlusion of the sculpted prosthetic model confirmed by bringing model teeth replicated in the opposing cast into bite-like contacting registration with the occlusal surfaces of the prosthetic model and adjacent teeth replicas of the master cast. This registration check generally must be repeated several times, to ensure proper sculpting of the occlusal surface of the die segment which serves as a model for fabricating a dental prosthesis. Moreover, it is essential that the biting contact or occlusion between the teeth replicated by the master cast and opposing cast precisely duplicate occlusion of the patient's teeth. Therefore, the master cast and opposing cast must be precisely and repetitively pivotably contacted against one another in a motion which simulates the opening and closing of a patient's jaws. Upon satisfactory completion of sculpting of lateral and occlusal surfaces of die segments, the die segment is used as a mold pattern for casting a metal, ceramic, or metal-ceramic composite dental prosthesis.
One type of device which is used to pivotably register master and opposing dental models or arches is referred as an articulator. For example, Cho, U.S. Pat. No. 6,019,601, Tray Modeling System With Articulator Assembly And Ejection Mechanism For Producing A Dental Model, discloses a pair of trays which are removably and pivotably joined together by detachable hinge members. Each tray has formed upon an upper surface thereof a rectangularly-shaped, trough-like depression, the longest inner facing side walls of the trough having formed therein alternating vertically disposed ribs and grooves. The device is used by pouring a thick paste of liquid die stone slurry into both a dental impression and the tray, and inverting the impression to enable the liquid die stone slurries in the impression and tray to commingle. When the die stone has solidified, the impression is removed from the cast, and the cast removed from the tray by punching through a frangible base panel in the tray, forcing the cast vertically outwards from the trough. The cast is then sawed into segments, which are returnable to precisely repeatable locations within the trough because of the interlocking ribs and grooves formed in the vertical walls of the cast by die stone solidifying in the grooves and ribs, respectively, of the trough side walls, during hardening of the die stone. In the same manner, an opposing cast is made in the other tray, and the trays pivoted towards one another on the hinge pins to precisely and repeatedly bring the occlusal surfaces of the opposing cast and master cast into occlusal registration.
The Cho modeling system and articulator provide a convenient means for preparing and articulating dental models. However, some dental technicians prefer working with die segments which have an elongated cylindrical pin protruding from the base of the die segment. In modeling systems using pinned die segments, the pins are insertably received in holes provided in the base of a tray, and are used to reproducibly position or relate individual die segments to adjacent portions of the master cast. Moreover, a pin protruding from a die segment provides a convenient handle which enables the dental technician to hold a die segment while working on it, including rotating the die segment a full 360 degrees by twisting the die segment pin between the thumb and forefinger of the dental technician. Thus, Sim, U.S. Pat. No. 6,402,513, Dental Model Articulator, discloses a dental model articulator which has pinned die segments. The dental model articulator disclosed in Sim utilizes a top insert which has front and rear upwardly protruding ridges that have grooved upper surfaces. The insert is detachably supported on a lower frame. To pour a master cast of a dental impression, a middle frame must be fastened to a lower frame and around the top insert by engaging slots on left and right sides of the middle frame with retentive latches which protrude upwards from the lower frame, on left and right sides of an upper opening in the lower frame which holds the top insert. According to the disclosure of Sim, the middle frame is discarded after completion of a second pour of liquid die stone through a bottom opening of lower frame, to form a perforated matrix for receipt of pins installed in the base of the first impression casting. The grooved insert is discarded after the first pour.
In U.S. patent application Ser. No. 10/376,325, filed Feb. 26, 2003, three of the present inventors disclosed an improved dental modeling system which includes a modeling tray that molds die segment bases which each have short ribs and grooves that enable removal of the die segments from a dental model cast in the tray, and re-insertion of the segments into the tray in precise re-registration with adjacent portions of the cast. That capability is provided by a combination of alignment forces between complementary-shaped grooves and ribs in vertical walls of a shallow trough-like depression in the upper part of a modeling tray, in combination with alignment forces provided by a tapered pin which protrudes downwardly from the die segment and which is received in a pin bore formed in a hardened die stone base matrix cast located in a relatively deep, lower concave opening of the tray. Also, in U.S. patent application Ser. No. 10/461,968, filed Jun. 12, 2003, the aforementioned three inventors disclosed a further improved dental modeling system which employed re-usable modeling trays.
Although the above-disclosed systems function admirably in accomplishing their intended purposes, there are occasions in which it would be desirable to provide a dental prostheses modeling system which does not require a second pour of liquid die stone to form a stone base matrix, in addition to the first pour required for molding the dental cast itself, while still enabling die segments to be removed and re-inserted into precise, stable relationship with adjacent portions of a dental impression cast, without requiring that die segments be provided with pins. Also, it would be desirable to provide a dental modeling system in which selected die segments are optionally fitted with a pin which depends downwardly from a die segment, to facilitate manipulation of the segment by a technician during the manufacture of a dental restoration. It would also be desirable to provide a dental modeling system for full arch casts in addition to quadrant casts, with the aforementioned capabilities. Morever, it would be desirable to provide a means for attaching pairs of full arch casts in an adjustably articulatable fashion to a rugged, dimensionally stable three-dimensional clinical dental articulator of the type used in dental labs, in the usual manner of using molded plaster or other conventional means to attach the casts to upper and lower articulator arms, yet enabling the full arch casts and/or restorations made therefrom to be easily removed from the lab articulator, returned to the dentist, and re-attached to a low cost, disposable display or presentation articulator hinge mechanism for viewing by the dentist and his or her patient. The present invention was conceived of to fulfill the foregoing needs.